Deliverable surgical instrument

ABSTRACT

In various embodiments, a shaftless end effector is disclosed. The end effector can comprise an anvil assembly including a staple forming surface. The end effector can also comprise a staple cartridge channel configured to receive a staple cartridge therein. The end effector can include a closure system configured to close the anvil. In various instances, the closure system can also form the staples contained within the staple cartridge. The end effector can also include a cutting member configured to cut tissue positioned intermediate the anvil and the staple cartridge. In various instances, the cutting member can be actuated by the closure system. In other instances, the end effector can include an independent system for actuating the cutting member. In various instances, the end effector can be delivered to a surgical site through a trocar and then operated by one or more actuators that are assembled to the end effector.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 14/178,840, entitled DELIVERABLE SURGICAL INSTRUMENT, filed Feb. 12, 2014, now U.S. Patent Application Publication No. 2015/0223809, the entire disclosure of which is hereby incorporated by reference herein.

BACKGROUND

The present application relates to surgical instruments and, in various embodiments, to surgical stapling and/or cutting instruments and staple cartridges for use therewith.

BRIEF DESCRIPTION OF THE DRAWINGS

The features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:

FIG. 1 is a cross-sectional view of a shaftless surgical system including a shaftless end effector in accordance with at least one embodiment;

FIGS. 2-6 illustrate various cross-sectional views of the shaftless surgical system of FIG. 1;

FIG. 7 is a cross-sectional view of the end effector of FIG. 1 in an open condition, wherein the end effector includes an anvil in an open position;

FIG. 8 is a cross-sectional view of the end effector of FIG. 1 in a closed condition;

FIG. 9 is a cross-sectional view of the end effector of FIG. 1 illustrating a closure system of the end effector engaged with the anvil;

FIG. 10 is a cross-sectional view of the end effector of FIG. 1 in a fired condition;

FIG. 11 is a cross-sectional view of a shaftless end effector in accordance with at least one alternative embodiment and a grasper configured to manipulate the end effector;

FIG. 12 is a cross-sectional view of a shaftless end effector in accordance with at least one alternative embodiment and an actuator configured to manipulate the end effector;

FIG. 13 illustrates the actuator of FIG. 12 detached from the end effector of FIG. 12;

FIG. 14 is a cross-sectional view of an end effector in accordance with at least one embodiment comprising a detachable guide tether;

FIG. 15 is a detail view of a frangible section connecting the guide tether of FIG. 14 to the end effector of FIG. 14;

FIG. 16 illustrates the detachable guide tether of FIG. 14 in a detached state;

FIG. 17 is a cross-sectional view of a shaftless end effector in accordance with at least one alternative embodiment including a rotatable drive system;

FIG. 18 is a cross-sectional view of a knife member of the end effector of FIG. 17;

FIG. 19 is a cross-sectional view of the end effector of FIG. 17 illustrated in a fired condition;

FIG. 20 is a cross-sectional end view of the end effector of FIG. 17;

FIG. 21 is a cross-sectional view of the end effector of FIG. 17 illustrated with the knife member of FIG. 18 in a fully-actuated position;

FIG. 22 is a cross-sectional view of a shaftless end effector in accordance with at least one alternative embodiment comprising a rotatable closure system and a firing system;

FIG. 23 is a cross-sectional view of a knife member of the end effector of FIG. 22;

FIG. 24 is a cross-sectional end view of the end effector of FIG. 22;

FIG. 25 is a cross-sectional view of the end effector of FIG. 22 illustrated in a closed and fully-fired condition;

FIG. 26 is a cross-sectional view of the end effector of FIG. 22 illustrated in a fully-actuated condition;

FIG. 27 illustrates an embodiment of an integrated closure and firing mechanism for interfacing with a shaftless end effector;

FIG. 28 illustrates one embodiment of a shaftless end effector configured to be operably engaged with the integrated closure and firing mechanism of FIG. 27;

FIG. 29 illustrates the integrated closure and firing mechanism of FIG. 27 attached to the end effector of FIG. 28;

FIG. 30 illustrates the shaftless end effector of FIG. 28 in a closed condition;

FIGS. 31-32 illustrate various cross-sectional views of the shaftless end effector of FIG. 28; and

FIG. 33 illustrates the end effector of FIG. 28 in a partially-actuated condition.

DETAILED DESCRIPTION

The Applicant of the present application also owns the U.S. Patent Applications identified below which are each herein incorporated by reference in their respective entirety:

U.S. patent application Ser. No. 12/894,311, entitled SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS; now U.S. Pat. No. 8,763,877;

U.S. patent application Ser. No. 12/894,340, entitled SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS; now U.S. Pat. No. 8,899,463;

U.S. patent application Ser. No. 12/894,327, entitled JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS; now U.S. Pat. No. 8,978,956;

U.S. patent application Ser. No. 12/894,351, entitled SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS; now U.S. Pat. No. 9,113,864;

U.S. patent application Ser. No. 12/894,338, entitled IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT; now U.S. Patent No. 8,864,007;

U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER; now U.S. Patent Application Publication No. 2012/0080344;

U.S. patent application Ser. No. 12/894,312, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS; now U.S. Pat. No. 8,925,782;

U.S. patent application Ser. No. 12/894,377, entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE; now U.S. Pat. No. 8,393,514;

U.S. patent application Ser. No. 12/894,339, entitled SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT; now U.S. Pat. No. 8,840,003;

U.S. patent application Ser. No. 12/894,360, entitled SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM; now U.S. Pat. No. 9,113,862;

U.S. patent application Ser. No. 12/894,322, entitled SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS; now U.S. Pat. No. 8,740,034;

U.S. patent application Ser. No. 12/894,350, entitled SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES; now U.S. Patent Application Publication No. 2012/0080478;

U.S. patent application Ser. No. 12/894,383, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS; now U.S. Pat. No. 8,752,699;

U.S. patent application Ser. No. 12/894,389, entitled COMPRESSIBLE FASTENER CARTRIDGE; now U.S. Pat. No. 8,740,037;

U.S. patent application Ser. No. 12/894,345, entitled FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT; now U.S. Pat. No. 8,783,542;

U.S. patent application Ser. No. 12/894,306, entitled COLLAPSIBLE FASTENER CARTRIDGE; now U.S. Pat. No. 9,044,227;

U.S. patent application Ser. No. 12/894,318, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS; now U.S. Pat. No. 8,814,024;

U.S. patent application Ser. No. 12/894,330, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX; now U.S. Pat. No. 8,757,465;

U.S. patent application Ser. No. 12/894,361, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX; now U.S. Pat. No. 8,529,600;

U.S. patent application Ser. No. 12/894,367, entitled FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX; now U.S. Pat. No. 9,033,203;

U.S. patent application Ser. No. 12/894,388, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER; now U.S. Pat. No. 8,474,677;

U.S. patent application Ser. No. 12/894,376, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES; now U.S. Pat. No. 9,044,228;

U.S. patent application Ser. No. 13/097,865, entitled SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS; now U.S. Pat. No. 9,295,464;

U.S. patent application Ser. No. 13/097,936, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER; now U.S. Pat. No. 8,657,176;

U.S. patent application Ser. No. 13/097,954, entitled STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION; now U.S. Patent Application Publication No. 2012/0080340;

U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF; now U.S. Patent Application Publication No. 2012/0080336;

U.S. patent application Ser. No. 13/097,928, entitled TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS; now U.S. Pat. No. 8,746,535;

U.S. patent application Ser. No. 13/097,891, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL; now U.S. Pat. No. 8,864,009;

U.S. patent application Ser. No. 13/097,948, entitled STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION; now U.S. Pat. No. 8,978,954;

U.S. patent application Ser. No. 13/097,907, entitled COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY; now U.S. Pat. No. 9,301,755;

U.S. patent application Ser. No. 13/097,861, entitled TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES; now U.S. Pat. No. 9,113,865;

U.S. patent application Ser. No. 13/097,869, entitled STAPLE CARTRIDGE LOADING ASSEMBLY; now U.S. Pat. No. 8,857,694;

U.S. patent application Ser. No. 13/097,917, entitled COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS; now U.S. Pat. No. 8,777,004;

U.S. patent application Ser. No. 13/097,873, entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION; now U.S. Pat. No. 8,740,038;

U.S. patent application Ser. No. 13/097,938, entitled STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS; now U.S. Pat. No. 9,016,542;

U.S. patent application Ser. No. 13/097,924, entitled STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,168,038;

U.S. patent application Ser. No. 13/242,029, entitled SURGICAL STAPLER WITH FLOATING ANVIL; now U.S. Pat. No. 8,893,949;

U.S. patent application Ser. No. 13/242,066, entitled CURVED END EFFECTOR FOR A STAPLING INSTRUMENT; now U.S. Patent Application Publication No. 2012/0080498;

U.S. patent application Ser. No. 13/242,086, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK; now U.S. Pat. No. 9,055,941;

U.S. patent application Ser. No. 13/241,912, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT; now U.S. Pat. No. 9,050,084

U.S. patent application Ser. No. 13/241,922, entitled SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS; now U.S. Pat. No. 9,216,019;

U.S. patent application Ser. No. 13/241,637, entitled SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS; now U.S. Pat. No. 8,789,741;

U.S. patent application Ser. No. 13/241,629, entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR; now U.S. Patent Application Publication No. 2012/0074200;

U.S. patent application Ser. No. 13/433,096, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF CAPSULES; now U.S. Pat. No. 9,301,752;

U.S. patent application Ser. No. 13/433,103, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS; now U.S. Pat. No. 9,433,419;

U.S. patent application Ser. No. 13/433,098, entitled EXPANDABLE TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,301,753;

U.S. patent application Ser. No. 13/433,102, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR; now U.S. Pat. No. 9,232,941;

U.S. patent application Ser. No. 13/433,114, entitled RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,386,988;

U.S. patent application Ser. No. 13/433,136, entitled TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT; now U.S. Patent Application Publication No. 2012/0241492;

U.S. patent application Ser. No. 13/433,141, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION; now U.S. Patent Application Publication No. 2012/0241493;

U.S. patent application Ser. No. 13/433,144, entitled TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD; now U.S. Pat. No. 9,277,919;

U.S. patent application Ser. No. 13/433,148, entitled TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD; now U.S. Pat. No. 9,220,500;

U.S. patent application Ser. No. 13/433,155, entitled TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS; now U.S. Pat. No. 9,480,476;

U.S. patent application Ser. No. 13/433,163, entitled METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS; now U.S. Patent Application Publication No. 2012/0248169;

U.S. patent application Ser. No. 13/433,167, entitled TISSUE THICKNESS COMPENSATORS; now U.S. Pat. No. 9,220,501;

U.S. patent application Ser. No. 13/433,175, entitled LAYERED TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,332,974;

U.S. patent application Ser. No. 13/433,179, entitled TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS; now U.S. Pat. No. 9,364,233;

U.S. patent application Ser. No. 13/763,028, entitled ADHESIVE FILM LAMINATE; now U.S. Pat. No. 9,282,962;

U.S. patent application Ser. No. 13/433,115, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT; now U.S. Pat. No. 9,204,880;

U.S. patent application Ser. No. 13/433,118, entitled TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF MATERIALS; now U.S. Pat. No. 9,414,838;

U.S. patent application Ser. No. 13/433,135, entitled MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,517,063;

U.S. patent application Ser. No. 13/433,140, entitled TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME; now U.S. Pat. No. 9,241,714;

U.S. patent application Ser. No. 13/433,129, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS; now U.S. Pat. No. 9,211,120;

U.S. patent application Ser. No. 11/216,562, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 7,669,746;

U.S. patent application Ser. No. 11/714,049, entitled SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS, now U.S. Patent Application Publication No. 2007/0194082;

U.S. patent application Ser. No. 11/711,979, entitled SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 8,317,070;

U.S. patent application Ser. No. 11/711,975, entitled SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT, now U.S. Patent Application Publication No. 2007/0194079;

U.S. patent application Ser. No. 11/711,977, entitled SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES, now U.S. Pat. No. 7,673,781;

U.S. patent application Ser. No. 11/712,315, entitled SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS, now U.S. Pat. No. 7,500,979;

U.S. patent application Ser. No. 12/038,939, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 7,934,630;

U.S. patent application Ser. No. 13/020,263, entitled SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 8,636,187;

U.S. patent application Ser. No. 13/118,278, entitled ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 9,237,891;

U.S. patent application Ser. No. 13/369,629, entitled ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS, now U.S. Pat. No. 8,800,838;

U.S. patent application Ser. No. 12/695,359, entitled SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now U.S. Pat. No. 8,464,923;

U.S. patent application Ser. No. 13/072,923, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 8,567,656;

U.S. patent application Ser. No. 13/766,325, entitled LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR; now U.S. Patent Application Publication No. 2013/0256380;

U.S. patent application Ser. No. 13/763,078, entitled ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. Patent Application Publication No. 2013/0256383;

U.S. patent application Ser. No. 13/763,094, entitled LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS; now U.S. Pat. No. 9,788,834;

U.S. patent application Ser. No. 13/763,106, entitled END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER; now U.S. Pat. No. 9,592,050;

U.S. patent application Ser. No. 13/433,147, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS; now U.S. Pat. No. 9,351,730;

U.S. patent application Ser. No. 13/763,112, entitled SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES; now U.S. Patent Application Publication No. 2013/0256379;

U.S. patent application Ser. No. 13/763,035, entitled ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE; now U.S. Patent Application Publication No. 2013/0214030;

U.S. patent application Ser. No. 13/763,042, entitled RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME; now U.S. Patent Application Publication No. 2013/0221063;

U.S. patent application Ser. No. 13/763,048, entitled FASTENER CARTRIDGE COMPRISING A RELEASABLE TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,700,317;

U.S. patent application Ser. No. 13/763,054, entitled FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,272,406;

U.S. patent application Ser. No. 13/763,065, entitled FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,566,061;

U.S. patent application Ser. No. 13/763,021, entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER; now U.S. Pat. No. 9,386,984;

U.S. patent application Ser. No. 13/763,078, entitled ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. Patent Application Publication No. 2013/0256383;

U.S. patent application Ser. No. 13/763,095, entitled LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES; now U.S. Pat. No. 9,770,245;

U.S. patent application Ser. No. 13/763,147, entitled IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES; now U.S. Patent Application Publication No. 2013/0153636;

U.S. patent application Ser. No. 13/763,192, entitled MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES; now U.S. Pat. No. 9,615,826;

U.S. patent application Ser. No. 13/763,161, entitled RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME; now U.S. Patent Application Publication No. 2013/0153641;

U.S. patent application Ser. No. 13/763,177, entitled ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR; now U.S. Pat. No. 9,585,657;

U.S. patent application Ser. No. 13/763,037, entitled STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORTION; now U.S. Patent Application Publication No. 2013/0224857;

U.S. patent application Ser. No. 13/433,126, entitled TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH FEATURES; now U.S. Pat. No. 9,320,523;

U.S. patent application Ser. No. 13/433,132, entitled DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS; now U.S. Patent Application Publication No. 2013/0256373;

U.S. patent application Ser. No. 13/851,703, entitled FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN; now U.S. Pat. No. 9,572,577;

U.S. patent application Ser. No. 13/851,676, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH; now U.S. Patent Application Publication No. 2014/0291379;

U.S. patent application Ser. No. 13/851,693, entitled FASTENER CARTRIDGE ASSEMBLIES; now U.S. Pat. No. 9,332,984; and

U.S. patent application Ser. No. 13/851,684, entitled FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR AND A GAP SETTING ELEMENT; now U.S. Pat. No. 9,795,384.

Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment”, or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation. Such modifications and variations are intended to be included within the scope of the present invention.

The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the person of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, those of ordinary skill in the art will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.

Turning to the drawings wherein like numerals denote like components throughout the several views, FIG. 1 depicts a shaftless surgical system 2. The shaftless surgical system 2 comprises a trocar 4 and a shaftless end effector 6. In use, the trocar 4 is inserted through one or more openings formed in a patient, such as, for example, a natural orifice opening, a translumenal opening, a surgical opening, and/or any other suitable opening. In some embodiments, the trocar 4 comprises an endoscopic and/or laparoscopic instrument. The end effector 6 may be located within the trocar 4 when the trocar 4 is introduced to a surgical site. In certain embodiments, the end effector 6 may be inserted into the trocar 4 after the trocar 4 has been introduced to the surgical site. In some embodiments, an actuator is introduced into the proximal end of the trocar 4 to push the end effector 6 out of the trocar 4. In other embodiments, an actuator is introduced into the distal end of the trocar to pull the end effector 6 out of the trocar 4.

In various embodiments, the shaftless end effector 6 comprises a first jaw member 8 a and a second jaw member 8 b. The first jaw member 8 a comprises an anvil 10 having a staple-forming surface. The staple-forming surface can comprise a plurality of staple forming pockets therein. The first jaw member 8 a is moveably coupled to a second jaw member 8 b. The second jaw member 8 b comprises a longitudinal channel 42 configured to receive a staple cartridge 12. The staple cartridge 12 comprises a plurality of staples 14 disposed therein. A pin 15 extending from first jaw member 8 a is received within a slot 16 formed on the second jaw member 8 b. The pin 15 and the slot 16 are configured to allow pivoting (rotation) and/or vertical movement (translation) of the first jaw member 8 a with respect to the second jaw member 8 b. In various embodiments, the second jaw member 8 b may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc., and may be formed with spaced side walls. The first jaw member 8 a may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc., and have a staple forming undersurface comprising a plurality of staple forming pockets formed therein.

Various forms of staple cartridges may be employed with the various embodiments of the end effector 6 disclosed herein. In some embodiments, an implantable staple cartridge 12 may be used. In at least one embodiment, the staple cartridge 12 comprises a body portion 18 that comprises a compressible material such as, for example, a hemostatic material, oxidized regenerated cellulose (“ORC”) and/or a bioabsorbable foam in which lines of unformed metal staples 14, for example, are supported. In at least some embodiments, in order to prevent the alignment of the staples 14 within the cartridge body 18 from being affected and/or the hemostatic material from being activated during the introduction and positioning of the end effector 6 within a surgical site, the entire staple cartridge 12 may be coated or wrapped in a biodegradable film, such as, for example, a polydioxanone film sold under the trademark PDS®, a Polyglycerol sebecate (PGS) film, a biodegradable film formed from PGA (Polyglycolic acid, marketed under the trademark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl), and/or a composite of PGA, PCL, PLA, and/or PDS that would be impermeable until ruptured. The body portion 18 of the staple cartridge 12 is sized to be supported within the longitudinal channel 42 of the lower jaw member 8 b such that each staple 14 is aligned with a corresponding staple forming pocket in the anvil 10 when the anvil 10 is driven into forming contact with the staple cartridge 12. In various instances, the staple cartridge 12 can be removable from the end effector 6 and, in other instances, the staple cartridge 12 may not be removable from the end effector 6.

In use, the end effector 6 is positioned adjacent to target tissue. The end effector 6 is manipulated to capture or clamp the target tissue between the anvil 10 and the staple cartridge 12. Referring to FIG. 7, the anvil 10 is illustrated in an open position. The anvil 10 can be rotated downwardly toward the tissue T into a closed, or clamped, position, as illustrated in FIG. 8. A closure system configured to move the anvil 10 into a closed position is discussed in greater detail further below. The staples 14 are formed by moving the anvil 10 vertically, or downwardly, toward the staple cartridge 12 while maintaining the anvil 10 in a parallel, or an at least substantially parallel, orientation with respect to the staple cartridge 12 in order to bring the staple forming surface and the staple forming pockets of the anvil 10 into contact with the staple cartridge 12, as illustrated in FIG. 9. As the anvil 10 continues to move into the staple cartridge 12, referring now to FIG. 10, the legs of the staples 14 contact a corresponding staple forming pocket in the anvil 10 which serves to bend the staple 14 legs and form the staples 14 into a “B shape”, for example. Further movement of the anvil 10 towards the staple cartridge 12 will further compress and form the staples 14 to a desired final formed height.

Further to the above, the end effector 6 can comprise a closure system configured to close the anvil 10. FIG. 1 illustrates a closure system 20 comprising a proximal end slide 22 a and a distal end slide 22 b. The proximal end slide 22 a and the distal end slide 22 b can each comprise a cavity 24 for receiving a portion of the first jaw member 8 a and a portion of the second jaw member 8 b therein. The proximal slide 22 a comprises a slide portion 26 a extending longitudinally therefrom and the distal slide 22 b comprise a slide portion 26 b extending longitudinally therefrom. The slide portions 26 a, 26 b are slideably receivable within a longitudinal aperture 28 formed in the lower jaw member 8 b. FIGS. 2-6 illustrate various cross-sectional views of the shaftless surgical system 2 illustrated in FIG. 1. FIG. 2 illustrates a cross-sectional view of the shaftless surgical system 2 showing the trocar 4 and the distal slide 22 b. FIG. 3 illustrates a cross-sectional view of the shaftless surgical system 2 showing the distal slide 22 b and the cavity 24 defined therein for receiving a distal end of the first jaw member 8 a and a distal end of the second jaw member 8 b. FIG. 4 illustrates a cross-sectional view of the shaftless surgical system 2 showing the first jaw member 8 a comprising a recess configured to receive a portion of the distal slide 22 b, as described in greater detail further below. In some embodiments, the recess comprises a plurality of retention and/or depth gauge features 38, which will also be described in greater detail further below. The slide portion 26 b of the distal slide 22 b is further illustrated in FIG. 4 and is positioned within the longitudinal aperture 28 defined in the second jaw member 8 b. FIG. 5 illustrates a cross-sectional view of the shaftless surgical system 2 showing the first jaw member 8 a and the second jaw member 8 b at a location which is intermediate the proximal slide 22 a and the distal slide 22 b. FIG. 6 illustrates a cross-sectional view of the shaftless surgical system 2 showing the pin 15 and slot 16 coupling the first jaw member 8 a and the second jaw member 8 b. FIG. 6 further illustrates the proximal slide 22 a and the proximal slide portion 26 a. The proximal slide portion 26 a is slideably received within the longitudinal aperture 28 defined in the second jaw 8 b. In various instances, the slide portion 26 a and/or the slide portion 26 b can support the second jaw 8 b as the first jaw 8 a is pushed toward the second jaw 8 b to deform the staples as discussed above.

FIG. 7 illustrates the end effector 6 in a deployed position, i.e., a position within a patient. As outlined above, the end effector 6 can be deployed from the trocar 4, for example, by inserting a push rod into the trocar 4 in order to push the shaftless end effector 6 out of the trocar 4. When deployed from the trocar 4, the first jaw member 8 a and the second jaw member 8 b can assume an open position and/or can be manipulated to assume an open position. In at least one embodiment, the anvil 10 is biased into an open position by an anvil spring (not shown) and/or another biasing arrangement. The anvil spring biases the first jaw member 8 a and the second jaw member 8 b into an open position such that, when the shaftless end effector 6 is deployed from the trocar 4, the shaftless end effector 6 assumes the open position illustrated in FIG. 7.

FIGS. 7-10 illustrate a tissue clamping and staple-forming process. In FIG. 7, a target tissue “T” is positioned between the anvil 10 and the staple cartridge 12. The anvil 10 is pivoted with respect to the lower jaw member 8 b to an initial clamping, or partially-closed, position illustrated in FIG. 8. In some embodiments, a grasper and/or another instrument can be inserted through the trocar 4, and/or through another trocar, for example, to push the proximal slide 22 a and the distal slide 22 b toward one another, i.e., toward the center of the end effector 6 is used to transition the anvil 10 to a partially closed position. In various instances, the proximal slide 22 a can be configured to contact the first jaw 8 a and move the first jaw 8 a from its open position to a partially closed position. Once the first jaw 8 a has reached a partially closed position, the distal slide 22 b can be moved into contact with the first jaw 8 a. Thereafter, the slides 22 a and 22 b can be pushed toward one another at the same time and/or sequentially in order to compress the anvil 10 onto the target tissue “T” and clamp the target tissue “T” between the anvil 10 and the staple cartridge 12. FIG. 9 illustrates the initial staple formation wherein the anvil 10 has just come into contact with the staple cartridge 12. FIG. 10 illustrates the staples 14 in their final formed position.

Further to the above, the end slides 22 a, 22 b can each define a cavity 24 for receiving the first jaw member 8 a and the second jaw member 8 b therein. The inner surface of the cavity 24 defined in each of the end slides 22 a, 22 b can comprise a cam surface, such as cam surface 30, for example. In various instances, each cam surface 30 can comprise an angled surface, for example. In certain instances, the angled surfaces can be configured to engage angled surfaces on the first jaw 8 a. For example, the proximal end of the first jaw 8 a can comprise a follower surface 32 which can be engaged by the cam surface 30 defined on the proximal end slide 22 a as the proximal end slide 22 a is moved distally toward the distal end slide 22 b. Similarly, the distal end of the first jaw 8 a can comprise a follower surface 32 which can be engaged by the cam surface 30 defined on the distal end slide 22 b as the distal end slide 22 b is moved proximally toward the distal end slide 22 a. In various instances, the angle of the cam surface 30 can match an angle of the follower surface 32 while, in other instances, the angle of the cam surface 30 can be different than an angle of the follower surface 32. In certain instances, one set of surfaces 30, 32, such as the proximal set of surfaces, may be defined by a first matching angle and the other set of surfaces 30, 32, such as the distal set of surfaces, may be defined by a second matching angle which is different than the first matching angle. In various embodiments, the configurations of the cam surfaces 30 and the follower surfaces 32 can be selected to allow the anvil 10 to maintain an at least substantially parallel orientation with respect to the staple cartridge 12 in order to form of all staple 14 simultaneously.

In some embodiments, the end effector 6 can comprise at least one gauge configured to indicate the formed height of the staples. In various instances, the proximal end of the end effector 6 can include a formed height gauge 31 and/or the distal end of the end effector 6 can include a formed height gauge 31, for example. In certain instances, the proximal end slide 22 a and/or the distal end slide 22 b comprise a gauge element configured to indicate the formed height of the staples 14. In various instances, a gauge can include a series or an array of demarcations defined on the distal end of the second jaw 8 a and, in addition, a gauge element extending from the distal end slide 22 b. In at least one such embodiment, the gauge element can comprise an arm 34 including a head 36 and the array of demarcations can comprise a plurality of teeth 38 wherein the position of the head 36 relative to the teeth 38 can indicate the distance in which the anvil 10 has been pushed downwardly. Similarly, a gauge can include a series or an array of demarcations defined on the proximal end of the second jaw 8 a and a gauge element extending from the proximal end slide 22 a. Also similar to the above, the gauge element can comprise an arm 34 including a head 36 and the array of demarcations can comprise a plurality of teeth 38 wherein the position of the head 36 relative to the teeth 38 can indicate the distance in which the anvil 10 has been pushed downwardly. Referring again to FIG. 9, the anvil 10 has been positioned against the staple cartridge 12 and, in such a position, the head 36 of the gauge element extending from the proximal end slide 22 a has slid over the outer-most tooth 38 in the proximal array of teeth 38 and the head 36 of the gauge element extending from the distal end slide 22 b has slid over the outer-most tooth 38 in the distal array of teeth 38. This relative positioning of the gauge heads 36 with respect to the arrays of teeth 38 can indicate to a clinician that the staples 14 have not yet been deformed by the anvil 10. As the proximal end slide 22 a is moved inwardly, the proximal end slide 22 a can drive the proximal end of the first jaw 8 a downwardly and the head 36 extending therefrom can slide over one or more additional teeth 38. Similarly, as the distal end slide 22 b is moved inwardly, the distal end slide 22 b can drive the distal end of the first jaw 8 a downwardly and the head 36 extending therefrom can slide over one or more additional teeth 38. When the heads 36 have slid over all of the teeth 38, as illustrated in FIG. 10, the clinician can assume that the staples 14 have been fully formed.

Various embodiments disclosed herein employ a compressible staple cartridge 12 that supports staples in a substantially stationary position for forming contact by the anvil 10. In various embodiments, the anvil 10 is driven into the unformed staples 14 wherein, in at least one such embodiment, the degree of staple formation attained is dependent upon how far the anvil 10 is driven into the staples. Such an arrangement provides the surgeon with the ability to adjust the amount of forming or firing pressure applied to the staples and thereby alters the final formed height of the staples.

Further to the above, the gauge elements extending from the end slides 22 a and 22 b can comprise retention members which can be configured to hold and/or lock the end slides 22 a and 22 b in position. In various instances, the heads 36 of the gauge elements and/or the teeth 38 can include lock shoulders configured to, one, permit the end slides 22 a and 22 b to be moved inwardly and, two, resist the outward movement of the end slides 22 a and 22 b. In various embodiments, the gauges can comprise ratchet systems permitting movement in one direction but prohibiting movement in the opposite direction. In order to overcome the locking effects of the gauge elements, the heads 36 of the gauge elements can be raised and/or deflected away from the arrays of teeth 38. Once the gauge elements have been disengaged from the first jaw 8 a, the end slides 22 a, 22 b can be moved outwardly to permit the first jaw 8 a to open. As discussed above, the first jaw 8 a can be moved into its open position by a spring and/or can be pulled open by a grasper, such as grasper 154 (FIG. 11), for example

Previous end effectors extended from a shaft of a surgical instrument wherein one or more drive members extending through the shaft were utilized to operate the end effector. As the reader will appreciate, the end effector 6 is not attached to the shaft of a surgical instrument and, thus, is shaftless. In various instances, as discussed above, a grasper, for example, can be utilized to push the end slides 22 a, 22 b of the end effector 6 inwardly. The grasper can be configured to move the end slides 22 a, 22 b one at a time or simultaneously. In various instances, a closure mechanism, such as, for example, a grasper (not shown) is coupled to the shaftless closure system 20. In certain instances, the grasper is opened and the shaftless end effector 6 is positioned between two arms of the grasper. The grasper is transitioned from an open position to a closed position to cause the proximal slide 22 a and the distal slide 22 b to slide towards a middle point of the shaftless end effector 6. The cam surfaces 30 of the proximal slide 22 a and the distal slide 22 b interface with the follower surfaces 32 defined on the anvil 10, causing the anvil 10 to compress towards the staple cartridge 12. As discussed above, the anvil 10 can compress the target tissue “T” and deploy the staples 14 into the target tissue “T.” Once the staples 14 have been formed and fastened to the target tissue “T”, further to the above, the surgeon can open the grasper and remove it from the surgical site. The anvil 10 can then be opened to release the stapled tissue “T” and the end effector 6 can be removed from the surgical site. As the reader will appreciate, the staple body 18 crushed and captured by the staples 14 can remain behind, or implanted. The remaining “crushed” staple body 18 can act as a hemostatic material, a staple line reinforcement, and/or a compensator for variations in tissue thickness. As used herein the term “implantable” means that, in addition to the staples 14, at least a portion of the staple cartridge body 18 captured by the staples 14 will also remain in the patient. The implanted cartridge body 18 may or may not eventually be absorbed by the patient's body. Although the various embodiments are described herein with reference to implantable staple cartridges, one skilled in the art will recognize that non-implantable cartridges, i.e., cartridges in which the staple cartridge remains positioned within the shaftless end effector after it is fired, may also be used. In various instances, such surgical stapling arrangements can employ staple driving elements which can lift the staples towards the anvil.

Although the shaftless end effector 6 is illustrated comprising a proximal slide 22 a and a distal slide 22 b, the reader will recognize that either the proximal slide 22 a and/or the distal slide 22 b may be omitted. In some embodiments, after the staples have been formed or fired into the target tissue, the shaftless end effector 6 may be released, for example, by actuating a release mechanism. The release mechanism can release the proximal slide 22 a and/or the distal slide 22 b causing the anvil 10 to assume an open position.

In certain embodiments, the shaftless end effector 6 may be solely used as a tissue stapling device. However, in various embodiments, the shaftless end effector 6 comprises a cutting member 40. The cutting member 40 is configured to cut the target tissue “T” along a longitudinal axis of the end effector 6. In some embodiments, the cutting member 40 comprises a fixed blade. In at least one embodiment, the lower jaw member 8 b comprises a sharpened cutting member 40 configured to interface with a mating member formed on the anvil 10. When the anvil 10 is compressed towards the staple cartridge 12, the anvil 10 pushes the tissue T against the cutting member 40 which then cuts the target tissue T. In other embodiments, the cutting member can comprise a slideable cutting member deployable from an un-actuated position adjacent to the proximal end of the shaftless end effector 6 to an actuated position adjacent the distal end, for example. In at least one such instance, the cutting member can be configured to slideably extend through a slot in the anvil 10 and a centrally disposed slot in the staple cartridge 12. A slideable cutting member may be deployed, for example, by a rotatable shaft, which is described in greater detail further below. In some embodiments, the slideable cutting member comprises a sled for deploying the staples 14.

FIG. 11 illustrates an embodiment of a shaftless end effector 106. The shaftless end effector 106 is similar to the shaftless end effector 6 illustrated in FIGS. 1-10. The shaftless end effector 106 comprises a first jaw member 108 a and a second jaw member 108 b. The first jaw member 108 a comprises an anvil 110 having a plurality of staple forming pockets therein. The second jaw member 108 b comprises a channel 142 configured to receive a staple cartridge, such as, for example, an implantable staple cartridge. A shaftless closure system 120 is configured to transition the end effector 106 from an open position to a closed position and to deploy the staples of a staple cartridge located within the channel 142. The shaftless closure system comprises a proximal slide 122 a and a distal slide 122 b. The proximal slide 122 a and the distal slide 122 b are configured to slideably interface with the first jaw member 108 a and the second jaw member 108 b to drive the anvil 110 into contact with, and form the staples within, a staple cartridge. The proximal slide 122 a comprises an angled grasping portion which extends in a direction which is transverse to a longitudinal axis of the end effector 106. In various instances, the angled grasping portion can comprise a ski tip 150. The ski tip 150 can be configured to facilitate the insertion of the end effector 106 relative to or underneath certain tissue. The ski tip 150 comprises a grasping section 152 configured to interface with a grasper 154. The grasper 154 may comprise any suitable grasper, such as, for example, a grasping device configured for insertion through the trocar 4. The ski tip 150 can facilitate the placement of the shaftless end effector 106 under a vessel or target tissue, for example. In some embodiments, after positioning the shaftless end effector 106 under the target tissue, the grasper 154 is used to transition the shaftless end effector 106 from the open position illustrated in FIG. 11 to a partially closed position. The grasper 154 and/or an additional mechanical actuator is interfaced with the shaftless closure system 120 to transition the shaftless end effector 106 from a partially-closed position to a fired position by pushing the slides 122 a and 122 b toward one another. Although the ski tip 150 is illustrated as coupled to the proximal slide 122 a, a ski tip 150 may extend from the distal slide 122 b.

FIGS. 12-13 illustrate one embodiment of a shaftless end effector 206. The shaftless end effector 206 comprises a first jaw member 208 a and a second jaw member 208 b. The first jaw member 208 a comprises an anvil 210 having a plurality of staple forming pockets therein. The second jaw member 208 b comprises a longitudinal channel 242 configured to receive a staple cartridge, such as, for example, an implantable staple cartridge. The first jaw member 208 a and the second jaw member 208 b are coupled by a pin 215 and a slot 216. The pin 215 enables pivotal and vertical movement of the anvil 210 with respect to the second jaw member 208 b. A shaftless closure system 220 is configured to transition the shaftless end effector 206 from an open position to a closed position. The shaftless closure system comprises a proximal slide 222 a and a distal slide 222 b. The proximal slide 222 a and the distal slide 222 b each comprise a cam formed thereon configured to interface with a bevel formed on the anvil 210. The interface between the cams of the proximal slide 222 a and the distal slide 222 b and the bevels of the first jaw 208 a can drive the anvil 210 into contact with the staple cartridge while maintaining the anvil 210 in a substantially parallel configuration with respect to the second jaw member 208 b. The proximal slide 222 a can comprise a coupling mechanism 258 configured to couple a detachable guide tether 256 to the shaftless end effector 206. In some embodiments, the guide tether 256 comprises an angled plane 260. The angled plane 260 extends at an angle with respect to the longitudinal plane of the second jaw member 208 b. The angled plane 260 may comprise, for example, a ski tip. The guide tether 256 may be manipulated by a surgeon to position the shaftless end effector 206 at a treatment site. For example, in one embodiment, the detachable guide tether 256 extends proximally through a trocar and out of the patient and may be pulled by the surgeon to position the shaftless end effector 206. Once the shaftless end effector 206 has been positioned, the guide tether 256 can be detached from the shaftless end effector 206 as illustrated in FIG. 13. Although the guide tether 256 is illustrated attached to the proximal slide 222 a, the reader will recognize that a coupling mechanism 258 may be formed on the distal slide 222 b and the guide tether 256 may be coupled to the distal slide 222 b. In any event, the guide tether 256 may be used as an actuator to rotate the anvil 210 into a partially closed position by pushing the slide 222 a and/or the slide 222 b inwardly.

FIG. 14 illustrates an embodiment of a shaftless end effector 306 comprising a tearable guide tether 356. The shaftless end effector 306 comprises a first jaw member 308 a and a second jaw member 308 b. The first jaw member 308 a comprises an anvil 310 having a plurality of staple forming pockets therein. The second jaw member 308 b comprises a longitudinal channel 342 configured to receive a staple cartridge, such as, for example, an implantable staple cartridge. The first jaw member 308 a and the second jaw member 308 b are coupled by a pin 315 and a slot 316. The pin 315 enables pivotal and vertical movement of the anvil 310 with respect to the second jaw member 308 b. A shaftless closure system 320 is configured to transition the shaftless end effector 306 from an open position to a closed position. The shaftless closure system comprises a proximal slide 322 a and a distal slide 322 b. The proximal slide 322 a and the distal slide 322 b each comprise a cam formed thereon and configured to interface with bevels formed on the anvil 310. The interface between the cams of the proximal slide 322 a and the distal slide 322 b and the bevels on the anvil 310 drive the anvil 310 into contact with the staple cartridge while maintaining the anvil 310 in a substantially parallel configuration with respect to the second jaw member 308 b. The proximal slide 322 a is coupled to a guide tether 356 by a tearable section 358. The guide tether 356 may extend proximally through a trocar 4 and may be manipulated by a surgeon to position the shaftless end effector 306 at a target site. After positioning the shaftless end effector 306, the guide tether 356 can be released from the shaftless end effector 306 by tearing the tearable section 358. FIG. 15 illustrates the tearable section 358 of the guide tether 356 coupled to the shaftless end effector 306. FIG. 16 illustrates the tearable section 358 after the tether 356 is separated from the shaftless end effector 306.

FIG. 17 illustrates an embodiment of a shaftless end effector 406 comprising a drive system 420. The shaftless end effector 406 comprises a first jaw member 408 a and a second jaw member 408 b. The first jaw member 408 a comprises an anvil 410 having a plurality of staple forming pockets formed therein. The second jaw member 408 b comprises a longitudinal channel 442 configured to receive a staple cartridge 412 therein. The staple cartridge 412 comprises a plurality of staples 14. The first jaw member 408 a and the second jaw member 408 b are pivotally coupled. A pin 415 coupled to the first jaw member 408 a is slideably retained within a slot 416 formed in the second jaw member 408 b. The pin 415 and the slot 416 enable the anvil 410 to pivot with respect to the second jaw member 408 b and to move vertically towards the second jaw member 408 b.

A rotatable shaft 464 extends longitudinally through the second jaw member 408 b. The rotatable shaft 464 is operably engaged with a proximal slide 422 a and a distal slide 422 b of the drive system 420. The proximal slide 422 a and the distal slide 422 b can each comprise a cam 430. One and/or both of the cams 430 are configured to engage the anvil 410, rotate the anvil 410 into a closed position, and translate the anvil 410 downwardly toward the cartridge 412. The shaft 464 comprises a proximal drive end 466 extending from the proximal slide 422 a. In various instances, a rotatable input, such as rotation mechanism 468, for example, can be coupled to the proximal drive end 466 to rotate the rotatable shaft 464. The shaft 464 can further comprise a first threaded portion 465 a, a second threaded portion 465 b, and a third threaded portion 465 c. The first threaded portion 465 a can be threadably engaged with a threaded longitudinal aperture defined in the proximal slide 422 a. When the shaft 464 is rotated in a first direction, the first threaded portion 465 a can displace the proximal slide 422 a toward the distal slide 422 b. The second threaded portion 465 b can be threadably engaged with a threaded longitudinal aperture defined in the distal slide 422 b. When the shaft 464 is rotated in the first direction, the second threaded portion 465 b can displace the distal slide 422 b toward the proximal slide 422 a. In order to achieve such relative motion, in various embodiments, the first threaded portion 465 a can comprise right-hand threads while the second threaded portion 465 b can comprise left-hand threads, for example. When the proximal slide 422 a and the distal slide 422 b are moved toward each other, one and/or both of the slides 422 a and 422 b can rotate the anvil 410 into a closed position and push the anvil 410 downwardly to crush the staples 14.

FIGS. 17, 19, and 21 illustrate the operation of the shaftless end effector 406 transitioning from an open condition to a fired condition. As shown in FIG. 17, a target tissue “T” is positioned between the anvil 410 and the staple cartridge 412 when the anvil 410 is in an open position. The shaftless end effector 406 is transitioned to a partially-closed position by pivoting the anvil 410 with respect to the second jaw member 408 b. In some instances, the anvil 410 may be pivoted by, for example, applying a force to the anvil 410 with a grasper inserted through a trocar 4. In other instances, the anvil 410 may be moved into an at least partially-closed position by the proximal slide 422 a. In any event, the rotatable shaft 464 is rotated to cause the proximal slide 422 a and the distal slide 422 b to move longitudinally towards a center point of the shaftless end effector 406. The shaft 464 can be rotated until the proximal slide 422 a and the distal slide 422 b fully compress the anvil 410 against the cartridge 412 and configure the shaftless end effector 406 in a fired condition, as illustrated in FIG. 19. In other situations, the shaft 464 can be rotated to partially compress the cartridge 412 and partially form the staples 14. In various instances, the proximal slide 422 a and the distal slide 422 b can contact the first jaw 408 a at the same time or at different times. In at least one instance, the proximal slide 422 a can contact the first jaw 408 a before the distal slide 422 b contacts the first jaw 408 a.

Referring again to FIG. 17, the end effector 406 can further include a cutting member, such as cutting member 440, for example. When the end effector 406 is in an open condition, as illustrated in FIG. 17, the cutting member 440 can be positioned in a proximal, unadvanced position. As illustrated in FIG. 18, the cutting member 440 can include a threaded longitudinal aperture 470 defined therein wherein the shaft 464 can extend through the longitudinal aperture 470. In the proximal, unadvanced position of the cutting member 440, the threaded aperture 470 may not be threadably engaged with the shaft 464. More particularly, the shaft 464 can include an unthreaded portion 467 extending between the first threaded portion 465 a and the third threaded portion 465 c and, when the cutting member 440 is in its proximal, unadvanced position, the unthreaded portion 467 of the shaft 464 can be positioned within the threaded aperture 470. In such circumstances, the shaft 464 may not directly move the cutting member 440 when the shaft 464 is rotated; however, referring to FIGS. 17 and 19, the cutting member 440 can be advanced distally, at least initially, by the proximal slide 422 a. Stated another way, the proximal slide 422 a can push the cutting member 440 toward the cartridge 412 when the proximal slide 422 a is moved inwardly by the rotation of the shaft 464, as discussed above. In various instances, the proximal slide 422 a can move the cutting member 440 into a pre-stage position, i.e., a position where the cutting member 440 is about to transect, but has not yet transected, the cartridge 412 and/or the tissue T captured between the cartridge 412 and the anvil 410. In various instances, the proximal slide 422 a can move the cutting member 440 into its pre-stage position when the proximal slide 422 a has reached its closed position, as illustrated in FIG. 19. In other instances, the proximal slide 422 a can move the cutting member 440 into its pre-stage position before the proximal slide 422 a has reached its closed position. In either event, the cutting member 440 can become operably engaged with the shaft 464 when the cutting member 440 has reached its pre-stage position. More particularly, the proximal slide 422 a can push the cutting member 440 distally until the threaded aperture 470 defined in the cutting member 440 becomes threadably engaged with the threaded position 465 c. Once the cutting member 440 has been threadably engaged with the shaft 464, further rotation of the shaft 464 in the first direction can advance the cutting member 440 distally, as illustrated in FIG. 21.

As outlined above, the first threaded portion 465 a can advance the proximal slide 422 a from its unactuated position (FIG. 17) to its fully actuated position (FIG. 19). As the shaft 464 is rotated, the proximal slide 422 a will advance along the length of the first threaded portion 465 a. Once the proximal slide 422 a has been moved into its fully actuated position, the proximal slide 422 a may no longer be engaged with the shaft 464 and further rotation of the shaft 464 in the first direction may not further advance the proximal slide 422 a. Stated another way, the first threaded portion 465 a may push the proximal slide 422 a to a point where the first threaded portion 465 a is no longer threadably engaged with the threaded aperture defined in the proximal slide 422 a and, at such point, an unthreaded portion 467 of the shaft 464 can be positioned within the threaded aperture. Similarly, the second threaded portion 465 b can advance the distal slide 422 b from its unactuated position (FIG. 17) to its fully actuated position (FIG. 19). As the shaft 464 is rotated, the distal slide 422 b will advance along the length of the second threaded portion 465 b. Once the distal slide 422 b has been moved into its fully actuated position, the distal slide 422 b may no longer be engaged with the shaft 464 and further rotation of the shaft 464 in the first direction may not further advance the distal slide 422 b. Stated another way, the second threaded portion 465 b may push the distal slide 422 b to a point where the second threaded portion 465 b is no longer threadably engaged with the threaded aperture defined in the distal slide 422 b and, at such point, an unthreaded portion 467 of the shaft 464 can be positioned within the threaded aperture 470. In various instances, the proximal slide 422 a can become disengaged from the first threaded portion 465 a at the same time, or at least substantially the same time, that the distal slide 422 b becomes disengaged from the second threaded portion 465 b. In some instances, the proximal slide 422 a can become disengaged from the first threaded portion 465 a before or after the distal slide 422 b becomes disengaged from the second threaded portion 465 b. In various instances, the proximal slide 422 a can become disengaged from the first threaded portion 465 a at the same time, or at substantially the same time, that the cutting member 440 becomes engaged with the third threaded portion 465 c. In other instances, the proximal slide 422 a can become disengaged from the first threaded portion 465 a before or after the cutting member 440 becomes engaged with the third threaded portion 465 c.

After the knife 440 has been sufficiently advanced by the shaft 464 to incise the tissue T and/or incise the cartridge 412, the knife 440 can be retracted by rotating the shaft 464 in a second, or opposite, direction. In such instances, the knife 440 can travel back along the third threaded portion 465 c until it returns to its pre-staged position in which it is no longer threadably engaged with the third threaded portion 465 c. Similarly, the rotation of the shaft 464 in the second direction can return the proximal slide 422 a and the distal slide 422 b to their unactuated positions and allow the anvil 410 to be reopened. In certain instances, the cutting member 440 can contact the proximal slide 422 a as the cutting member 440 is being retracted in order to nudge the proximal slide 422 a back onto the first threaded portion 465 a. In various instances, the end effector 406 can further include a threaded member configured to ride on the shaft 464 and nudge the distal slide 422 b back onto the second threaded portion 465 b. In any event, the threaded portions of the shaft 464 can have the same thread pitch. In such instances, the portions of the end effector 406 displaced by the shaft 464 can move at the same speed. In other instances, one or more of the threaded portions of the shaft 464 can have a different thread pitch wherein, as a result, one or more of the components of the end effector 406 can move at different speeds for a given rotational speed of the shaft 464.

As the reader will appreciate, the end effector 406 includes a single rotational drive input which can close the anvil 410 in a first stage, deform the staples 14 in a second stage, and advance the knife 440 in a third stage. In certain instances, one or more of these stages may occur consecutively. In at least one instance, one or more of these stages may not overlap with each other. In various instances, one or more of these stages may occur simultaneously. In at least one instance, one or more of these stages may at least partially overlap with one or more other stages. In some instances, it may be desired for the staple forming stage to at least partially occur before the cutting stage. In other instances, it may be desired for the staple forming stage to be completed before the cutting stage begins. Such an embodiment may be desired in order to prevent the tissue T from being cut prior to being stapled. As described in greater detail below, certain embodiments can include two or more drive systems to perform the various operating stages of an end effector.

FIG. 22 illustrates an embodiment of a shaftless end effector 506 comprising a shaftless closure mechanism and a shaftless firing mechanism. The shaftless end effector 506 comprises a first jaw member 508 a and a second jaw member 508 b. The first jaw member 508 a comprises an anvil 510 having a staple forming surface comprising a plurality of staple forming pockets therein. The second jaw member 508 b comprises a longitudinal channel 542 configured to receive a staple cartridge 512 therein. The first jaw member 508 a and the second jaw member 508 b are pivotally coupled. The first jaw member 508 a comprises a pin 515 coupled to a slot 516 formed in the lower jaw member 508 b. The pin 515 allows the first jaw member 508 a to move pivotally and vertically with respect to the second jaw member 508 b.

A rotatable shaft 564 extends longitudinally through the lower jaw member 508 b. The rotatable shaft 564 is coupled to a proximal slide 522 a and a distal slide 522 b of the closure mechanism 520. The proximal slide 522 a and the distal slide 522 b can each comprise a cam 530. Each cam 530 can comprise an angle configured to interface with one or more beveled surfaces formed on the first jaw 8 a. The rotatable shaft 564 comprises a drive end 566 which can be attached to a rotatable drive input, such as rotatable drive input 568, for example. Similar to the above, the rotatable drive input 568 can rotate the shaft 564 which can, in turn, move the proximal slide 522 a and the distal slide 522 b longitudinally towards a center point of the end effector 506. The movement of the proximal slide 522 a and the distal slide 522 b longitudinally towards the center point of the shaftless end effector 506 brings the cams 530 into contact with the first jaw 8 a in order to drive the anvil 510 into contact with the staple cartridge 512. The anvil 510 can compress the staple cartridge 512 and deploy the staples 14 through the target tissue “T”, as illustrated in FIG. 25. Such a system can comprise a first drive system of the end effector 506 configured to close the anvil 510 and fire the staples 14 in the end effector 506.

Further to the above, the end effector 506 can include a second drive system configured to incise the tissue T and/or the staple cartridge 512. Referring primarily to FIGS. 23 and 26, the shaftless end effector 506 can comprise a cutting member, such as cutting member 540, for example. The cutting member 540 can be longitudinally deployable within a channel formed in the second jaw member 508 b and/or the staple cartridge 512. In various instances, the cutting member 540 can include a longitudinal aperture, or clearance aperture, 570 extending therethrough. The drive shaft 564 can extend through the clearance aperture 570 and the drive shaft 564 may not be operably engaged with the cutting member 540. In various instances, the proximal slide 522 a can include a drive connector 576 extending therefrom. The drive connection 576 can include an aperture 571 defined therein which can be configured to receive a rod 580. The rod 580 can be positioned within a drive input 578 wherein the drive input 578 can be attached to the drive connector 576. Once the drive input 578 has been assembled to the drive connector 576, the rod 580 can be advanced into the end effector 506 in order to engage the cutting member 540, and/or a pusher member 541 positioned intermediate the rod 580 and the cutting member 540. In various instances, the rod 580 and/or the pusher member 541 can abut the cutting member 540 and advance the cutting member 540 distally to incise the cartridge 512 and/or the tissue T captured between the cartridge 512 and the anvil 510. In certain instances, the rod 580 can be retracted and the cutting member 540 can be left in its advanced position. In other instances, the rod 580 can comprise a distal attachment portion which can be configured to engage the cutting member 540, drive the cutting member 540 distally, and then pull the cutting member 540 proximally to its unfired position, for example. In at least one such embodiment, the cutting member 540 can include a socket defined therein configured to receive the attachment portion of the rod 580. After the cutting member 540 has been retracted, the rod 580 can become detached from the cutting member 540 by applying a sufficient force thereto.

As the reader can appreciate, the first drive system of the end effector 506 can be configured to close the anvil 510 and fire the staples 14 while the second drive system of the end effector 506 can be configured to incise the tissue T captured within the end effector 506. The first drive system and the second drive system can be operated independently of one another. For instance, the first drive system can be operated by a clinician wherein the clinician can decide whether to operate and/or when to operate the second drive system. FIGS. 22, 25, and 26 illustrate the shaftless end effector 506 being transitioned between an open position and a fired position. FIG. 22 illustrates the shaftless end effector 506 in an open position. Target tissue “T” is positioned between the anvil 510 and the staple cartridge 512. The anvil 510 is pivoted from an open position to a partially-closed position by moving the anvil 510 with a grasper, for example. The drive input 568 can be attached to the drive end 566 of the shaft 564 and the drive input 578 can be attached to the drive connector 576 at any suitable moment during the use of the surgical instrument. In some instances, one or both of the drive input 568 and the drive input 578 can be attached to the end effector 506 before the end effector 506 is positioned within a surgical site. In various instances, one or both of the drive input 568 and the drive input 578 can be attached to the end effector 506 after the end effector 506 has been positioned within a surgical site. In certain instances, the drive input 568 can be assembled to the drive end 566 independently of the drive input 578 being assembled to the drive end 576. In other instances, the drive input 568 and the drive input 578 can comprise an actuator assembly that can permit the drive input 568 and the drive input 578 to be assembled to the end effector 506 simultaneously. In use, the drive input 568 is actuated in order to rotate the rotatable shaft 564 and drive the proximal slide 522 a and the distal slide 522 b longitudinally towards a center point of the end effector 506. As discussed above, the cams 530 on the proximal slide 522 a and the distal slide 522 b can contact the first jaw 8 a to move the anvil 510 toward the staple cartridge 512 to form the staples as illustrated in FIG. 25. Also, in use, the drive input 578 is actuated in order to advance the firing member 540. In certain instances, the drive input 568 and the drive input 578 can be operated sequentially. In at least one instance, the drive input 568 can be operated and then the drive input 578 can be operated. In certain instances, the drive input 578 may not be operated until after the operation of the drive input 568 has ended. In at least one such instance, the drive input 568 can be operated to completely form, or suitably form, the staples 14 before the drive input 578 is operated to advance the knife 540. In various instances, the operation of the drive input 568 and the drive input 578 can at least partially overlap. In at least one such instance, the drive input 568 can be operated and, during the operation of the drive input 568, the drive input 578 can be operated.

FIG. 27 illustrates an embodiment of an integrated closure and firing mechanism 680 for interfacing with a closure system 620 of the shaftless end effector 606 illustrated in FIG. 28. The end effector 606 comprises a first jaw member 608 a, a second jaw member 608 b, and a frame 694. The first jaw member 608 a comprises an anvil 610. The second jaw member 608 b comprises a longitudinal channel 642 configured to receive a staple cartridge 612 therein. Referring to FIGS. 28, 30, and 32, the first jaw member 608 a and the second jaw member 608 b are pivotally coupled by a pivot pin 615. Referring primarily to FIG. 32, the pin 615 extends from the frame 694 and the first and second jaw members 608 a, 608 b are rotatably coupled to the frame 694 by the pin 615. The first jaw member 608 a and the second jaw member 608 b are pivotally moveable with respect to a center axis “A”. A shaftless closure system 620 is located at the proximal end of the shaftless end effector 606. The shaftless closure system 620 comprises a rotatable collar 690 comprising one or more threads 698 configured to rotatably interface with one or more threads 696 formed on the first jaw member 608 a and the second jaw member 608 b. In at least one instance, the threads 696 can comprise a continuous set of threads which extends around a perimeter defined by the first jaw member 608 a and the second jaw member 608 b. Rotation of the rotatable collar 690 in a first direction pivots the first jaw member 608 a and/or the second jaw member 608 b towards the central axis “A”, as illustrated in FIG. 30. Rotation of the collar 690 in a second, or opposite, direction pivots the first jaw member 608 a and/or the second jaw member 608 b away from the axis “A”, as illustrated in FIG. 29. As described in greater detail below, the collar 690 can include a connection portion that can be operably attached to a drive input. The end effector 606 can further include a cutting member 640 configured to incise the staple cartridge 612 and/or the tissue captured between the cartridge 612 and the anvil 610. The cutting member 640 can include a connection portion, such as connection member 643, for example, which extends proximally from the cutting portion 672 of the cutting member 640. As described in greater detail below, the connection member 643 can be operably attached to a drive input. In various instances, the frame 694 can include a longitudinal aperture 693 defined therein wherein the connection member 643 can be slideably received within the aperture 693.

Referring primarily to FIG. 27, the firing mechanism 680 can include a frame 682, a rotatable outer drive 686, and a translatable inner drive 688. Referring to FIGS. 28-30, the rotatable collar 690 can include an opening 695 defined therein which can be configured to receive the frame 682 of the firing mechanism 680. In various instances, the frame 682 can be closely received within the opening 695. In certain instances, the frame 682 can include a longitudinal aperture 681 defined therein which can be configured to receive at least a portion of the frame 694 of the end effector 604. Similar to the above, the frame 694 can be closely received within the aperture 681 of the frame 682. In various instances, the frame 694 and the frame 682 can be press-fit together. In certain instances, the frame 682 can be press-fit between the frame 694 and the collar 690. In some instances, a bayonet connection can be formed between the frame 682 and the frame 694. In at least one embodiment, the frame 694 can include one or more bayonet slots 692 defined therein which can each be configured to receive a post 699 extending inwardly from the frame 682. In order to assemble the frame 682 to the frame 694, the posts 699 can be positioned within the slots 692 and pushed distally until they reach a turn or bend in the slots 692. At such point, the frame 682 can be rotated or twisted in order to lock the posts 699 within the slots 692. In order to disconnect the frame 682 from the frame 694, the frame 682 can be rotated in the opposite direction to move the posts 699 into an unlocked position such that the frame 682 can then be pulled proximally away from the frame 694.

As discussed above, the collar 690 can comprise a connection portion. In various instances, the collar 690 can comprise one or more drive slots 691 defined therein which can be configured to receive at least a portion of the rotatable outer drive 686 of the firing mechanism 680. In certain instances, the rotatable outer drive 686 can include one or more drive tabs 687 which can be positioned within the drive slots 691. In at least one instance, the collar 690 can include a first drive slot 691 located on a first side of the collar 690 and a second drive slot 691 located on a second, or opposite, side of the collar 690 and, correspondingly, the rotatable outer drive 686 can include a first drive tab 687 positionable within the first drive slot 691 a second drive tab 687 positionable within the second drive slot 691. In use, the drive tabs 687 can transmit rotational motion from the rotatable outer drive 686 to the rotatable collar 690. In various instances, the drive tabs 687 can be closely received within the drive slots 691 such that the drive tabs 687 can engage the sidewalls of the drive slots 691 that they are positioned within. In use, the outer drive 686 can be rotated in a first direction in order to rotate the collar 690 in a first direction and close the end effector 606. As outlined above, the outer drive 686 can be utilized to close the end effector 606, compress the cartridge 612, and deform the staples 14. At any suitable point during the use of the end effector 606, the outer drive 686 can be rotated in a second, or opposite, direction in order to rotate the collar in a second, or opposite, direction and open the end effector 606.

As discussed above, the cutting member 640 can include a connection member 643. In various instances, the connection member 643 can include a connection slot 644 defined therein which can be configured to receive at least a portion of the translatable inner drive 688 of the firing mechanism 680. In certain embodiments, the inner drive 688 can include a drive end 684 which can be releasably retained in the connection slot 644. As illustrated in FIGS. 29 and 30, the inner drive 688 can be inserted into the frame aperture 693 to connect the drive end 684 to the cutting member 640. In use, the inner drive 688 can be pushed distally in order to push the cutting member 640 distally and transect the staple cartridge 612 and/or the tissue positioned between the staple cartridge 612 and the anvil 610. In various instances, the inner drive 688 may be operated after the outer drive 686 is operated. In at least one such instance, the staples 14 can be completely formed before the cutting member 640 is advanced. In other instances, the inner drive 688 and the outer drive 686 can be operated simultaneously.

In use, the rotatable collar 690 may or may not be able to pivot the jaws 608 a and 608 b into their completely closed positions. Such instances can typically arise when the tissue captured between the jaws 608 a and 608 b is thick. In various embodiments, the cutting member 640 can include one or more gap-setting flanges, such as flanges 641 a and 641 b, for example, which can facilitate the closure of the jaws 608 a and 608 b. More particularly, the cutting member 640 can include a first gap-setting flange 641 a which can be configured to engage the first jaw 608 a as the cutting member 640 is advanced distally. In various instances, the first flange 641 a, the second flange 641 b, and the cutting portion 672 can comprise an I-shaped or I-beam configuration, for example. Referring primarily to FIG. 31, the first flange 641 a can slide within a slot defined in the top surface of the first jaw 608 a. Similarly, the cutting member 640 can include a second gap-setting flange 641 b which can be configured to engage the second jaw 608 b as the cutting member 640 is advanced distally. Referring primarily to FIG. 31, the second flange 641 b can slide within a slot defined in the top surface of the second jaw 608 b. As the cutting member 640 is advanced distally, the flanges 641 a and 641 b can control, or set, the distance between the first jaw 608 a and the second jaw 608 b. In various instances, the tissue captured within the end effector 606, the staple cartridge 612, and/or a biasing spring of the end effector 606 can bias the jaws 608 a and 608 b outwardly against the flanges 641 a and 641 b, respectively. Despite this outward bias, the cutting member 640 can move the jaws 608 a and 608 b inwardly and/or hold the jaws 608 a and 608 b in their fully-closed positions. Some embodiments are contemplated in which the advancement of the cutting member 640 may be sufficient to close the jaws 608 a and 608 b, fire the staples 14, and incise the tissue T, for instance.

The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains. 

1-20. (canceled)
 21. An end effector and a shaft configured to staple patient tissue, wherein said end effector is configured to be introduced into a treatment area through an opening in the patient, and wherein said end effector comprises: a channel configured to receive a staple cartridge therein; an anvil; a first jaw; a second jaw movable relative to said first jaw between an unclamped position and a clamped position, wherein said second jaw comprises: a proximal pivot end rotatably coupled to said first jaw; and a movable distal end; a closure system configured to engage said movable distal end of said second jaw and said proximal pivot end of said second jaw; and a drive system comprising an input connector, wherein said drive system is configured to operate said closure system and move said second jaw to said clamped position, wherein said shaft is configured be inserted into the treatment area through another opening in the patient, and wherein said shaft comprises an actuator configured to be coupled to said drive system after said end effector and said shaft are introduced into the treatment area.
 22. The end effector and shaft of claim 21, wherein said staple cartridge comprises a plurality of staples removably stored therein.
 23. An end effector and a shaft configured to staple patient tissue, wherein said end effector is configured to be introduced into a treatment area through an opening in the patient, and wherein said end effector comprises: a jaw assembly, comprising: a channel configured to receive a staple cartridge therein; an anvil, comprising; a proximal pivot end; and a movable distal end; and a rotational joint connecting said anvil and said channel; a closure system configured to engage said movable distal end of said anvil and said proximal pivot end of said anvil to close said jaw assembly; and a drive system including an input connector, wherein said drive system is configured to operate said closure system, wherein said shaft is configured be inserted into the treatment area through another opening in the patient, and wherein said shaft comprises an actuator configured to be coupled to said drive system after said end effector and said shaft are introduced into the treatment area.
 24. The end effector and shaft of claim 23, wherein said staple cartridge comprises a plurality of staples removably stored therein.
 25. An end effector configured to be introduce into a surgical site through an opening in a patient, wherein said end effector is not attached to a surgical instrument as it passes through said opening into said surgical site, and wherein said end effector comprises: a channel configured to receive a staple cartridge therein; an anvil; a first jaw; a second jaw movable relative to said first jaw between an unclamped position and a clamped position, wherein said second jaw comprises: a proximal pivot end rotatably coupled to said first jaw; and a movable distal end; a closure system configured to engage said movable distal end of said second jaw and said proximal pivot end of said second jaw; and a drive system configured to operate said closure system and move said second jaw from said unclamped position to said clamped position, and wherein an actuator can be coupled to said drive system after said end effector is inserted through said opening into said surgical site.
 26. The end effector of claim 25, wherein said staple cartridge comprises a plurality of staples removably stored therein.
 27. An end effector configured to be introduced into a treatment area of a patient through an opening in the patient, wherein said end effector comprises: a channel configured to receive a staple cartridge therein; an anvil comprising a staple forming surface; a first jaw; a second jaw movable relative to said first jaw between an unclamped position and a clamped position, wherein said second jaw comprises: a proximal pivot end rotatably coupled to said first jaw; and a movable distal end; a closure system configured to engage said movable distal end of said second jaw and said proximal pivot end of said second jaw; a drive system comprising an input connector, wherein said drive system is configured to operate said closure system and move said second jaw from said unclamped position to said clamped position; and means for actuating said drive system, wherein said means for actuating said drive system is attachable to said end effector after said end effector has been introduced into the treatment area through the opening in the patient.
 28. The end effector of claim 27, wherein said staple cartridge comprises a plurality of staples removably stored therein.
 29. An end effector, comprising: a stapling assembly, comprising: a first jaw, comprising: a frame; a cartridge channel positioned in said frame; and a staple cartridge removably stored in said cartridge channel; and a second jaw, comprising an anvil, comprising: a proximal pivot end rotatably coupled to said frame; a movable distal end; and staple forming pockets; and a drive system, comprising: an actuator; a rotatable shaft operably positioned within said frame of said first jaw, wherein said rotatable shaft is configured to rotate in response to an actuation of said actuator; a proximal cam operably engaged with said rotatable shaft, wherein said proximal cam is configured to move distally and engage said stapling assembly to perform a clamping motion when said rotatable shaft is rotated; and a distal cam operably engaged with said rotatable shaft, wherein said distal cam is configured to move proximally and engage said stapling assembly during said clamping motion.
 30. The end effector of claim 29, wherein said staple cartridge comprises a plurality of staples removably stored therein. 